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Management of Cancer During Pregnancy: Obstetric and Neonatal Outcomes
  1. Isam M. Lataifeh, MD*,,
  2. Mahmoud Al masri, MD,
  3. Samer Barahmeh, MD,
  4. Lian Otay, MD,
  5. Nail Obeidat, MD*,
  6. Osama Badran, MD,
  7. Ghaleb Darwazeh, MD and
  8. Imad Jaradat, MD
  1. *Department of Obstetrics and Gynecology, Jordan University of Science and Technology, Irbid; and Departments of
  2. Surgery and
  3. Radiation Therapy, King Hussein Cancer Center, Amman, Jordan.
  1. Address correspondence and reprint requests to Isam M. Lataifeh, MD, CGO, Department of Obstetrics and Gynecology, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan. E-mail: isam_l{at}yahoo.com.

Abstract

Objective: This study aimed to assess the management and the obstetric and neonatal outcomes of pregnancies complicated by cancer.

Methods: A retrospective analysis of patients with cancer during pregnancy who were treated at King Hussein Cancer Center and King Abdullah University Hospital in Jordan between January 2002 and December 2009 was conducted. The medical records of patients with invasive cancer diagnosed during pregnancy and their newborns were reviewed to retrieve information on treatment and obstetric and neonatal outcomes. Numerical data were tested for normal distribution using Kolmogorov-Smirnov. Statistical analyses were conducted using SPSS 18.0.

Results: A total of 46 patients with a diagnosis of cancer in pregnancy were treated. The most common tumor types were breast cancer, hematologic malignancies, and gastrointestinal malignancies. In 17 patients, a miscarriage or a termination of pregnancy occurred in the first trimester. In 25 of 46 patients, a single or a combination of treatment modalities was commenced. The distribution of therapies was as follows: chemotherapy alone, n = 5; surgery alone, n = 7; surgery and chemotherapy, n = 6; surgery and radiation therapy, n = 1; surgery with chemotherapy and radiation therapy, n = 3; chemotherapy and radiation therapy, n = 1; interferon, n = 1; and hormonal therapy, n = 1. The mean (SD) gestational age at delivery was 35.7 (2.7) weeks. The mean birth weight was 2580 (870) g. Preterm delivery occurred in 17 patients. There were 4 neonatal deaths, 2 of them delivered at 33 weeks, 1 delivered at 34 weeks, and 1 delivered at 35 weeks gestation. There were no congenital malformations.

Conclusions: The remarkable finding is a high rate of iatrogenic preterm delivery with a high rate of neonatal mortality. Delivery should be postponed preferably until after a gestational age of 35 weeks.

  • Cancer
  • Chemotherapy
  • Neonatal
  • Pregnancy
  • Treatment

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Footnotes

  • The authors did not receive financial support for this study.

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